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Articular Cartilage Increases Transition Zone Regeneration in Bone-tendon Junction Healing

  • Original Article
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Clinical Orthopaedics and Related Research

Abstract

The fibrocartilage transition zone in the direct bone-tendon junction reduces stress concentration and protects the junction from failure. Unfortunately, bone-tendon junctions often heal without fibrocartilage transition zone regeneration. We hypothesized articular cartilage grafts could increase fibrocartilage transition zone regeneration. Using a goat partial patellectomy repair model, autologous articular cartilage was harvested from the excised distal third patella and interposed between the residual proximal two-thirds bone fragment and tendon during repair in 36 knees. We evaluated fibrocartilage transition zone regeneration, bone formation, and mechanical strength after repair at 6, 12, and 24 weeks and compared them with direct repair. Autologous articular cartilage interposition resulted in more fibrocartilage transition zone regeneration (69.10% ± 14.11% [mean ± standard deviation] versus 8.67% ± 7.01% at 24 weeks) than direct repair at all times. There was no difference in the amount of bone formation and mechanical strength achieved. Autologous articular cartilage interposition increases fibrocartilage transition zone regeneration in bone-tendon junction healing, but additional research is required to ascertain the mechanism of stimulation and to establish the clinical applicability.

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Acknowledgments

We thank J. Tai and W. Chong for assistance in animal surgery and sample processing.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong

    Margaret Wan Nar Wong FRCS, Ling Qin PhD & Kwok Sui Leung MD

  2. Lee Hysan Clinical Research Laboratories, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong

    Kwong Man Lee PhD

Authors
  1. Margaret Wan Nar Wong FRCS
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  2. Ling Qin PhD
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  3. Kwong Man Lee PhD
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  4. Kwok Sui Leung MD
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Corresponding author

Correspondence to Margaret Wan Nar Wong FRCS.

Additional information

One or more of the authors (MWNW, LQ, KSL) have received funding from Research Grants Council Earmarked Grant (Ref. CUHK 427597M).

Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Wong, M.W.N., Qin, L., Lee, K.M. et al. Articular Cartilage Increases Transition Zone Regeneration in Bone-tendon Junction Healing. Clin Orthop Relat Res 467, 1092–1100 (2009). https://doi.org/10.1007/s11999-008-0606-8

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  • DOI: https://doi.org/10.1007/s11999-008-0606-8

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